Refusing Surgery for Esophageal Cancer May Cause Severe Consequences for Patients
This press conference took place on January 30, 2018, at the STS 54th Annual Meeting in Fort Lauderdale, Florida. For more information, contact media@sts.org.
Patients with esophageal cancer who refuse surgery when it is recommended are less likely to survive long term than similar groups of patients who undergo an operation, according to research presented today at the 54th Annual Meeting of The Society of Thoracic Surgeons.
“Although it may be tempting for patients to opt for nonsurgical treatment for cardiothoracic diseases in order to avoid the perceived pain and complications of surgery, this choice may come with a price,” said senior author Brendon M. Stiles, MD, of Weill Cornell Medicine in New York, NY. “In our study, we show that even if patients recommended for surgery elect to pursue other treatments, they do more poorly than if they had included surgery as part of their treatment.”
Dr. Stiles and colleagues from Weill Cornell Medicine queried the National Cancer Database for patients with esophageal cancer from 2004 to 2014. The researchers identified 18,549 patients, including 708 patients who were recommended for surgery but declined. Within this group, instead of surgery, 41% (292) of patients were treated with definitive chemoradiation, 36% (256) with sequential chemotherapy/radiation, 8.2% (58) with radiation and/or chemotherapy alone, and 14% (102) received no treatment. Propensity matching was performed to compare patients who refused surgery to those treated with preoperative therapy followed by surgery (525 in each group). Median survival was significantly better in the neoadjuvant group with surgery than in patients who refused an operation, 32 months vs. 22 months, respectively.
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